<!DOCTYPE html>
<html xmlns:th="http://www.thymeleaf.org"
      th:replace="fragments/layout(title='能力评估',jsPaths='/static/js/mbassessment/mbassess.js,/static/plugins/jquery-migrate-1.2.1.min.js,/static/plugins/jquery.jqprint-0.3.js, /static/plugins/jquery.jqprint-0.3.js',cssPaths='/static/css/assessment/mbassess.css')">

<div class="right" th:fragment="right">
    <!--面包屑-->
    <div class="breadcrumb layui-bg-gray">
            <span class="layui-breadcrumb" lay-separator=">">
                <a th:href="@{/}">首页</a>
                <a href="javascript:void(0)">能力评估</a>
            </span>
    </div>

    <!--主体内容区-->
    <div class="form-content" id="print">
        <input type="hidden" name="id" id="pgId">
        <form class="layui-form">
            <div class="layui-row">
                <div class="layui-form-item">
                    <label class="layui-form-label must">老人姓名</label>
                    <div class="layui-input-inline">
                        <input type="text" name="elderlyName" id="elderlyName" readonly required
                               lay-verify="required" placeholder="请点击选择老人姓名" autocomplete="off" class="layui-input">
                        <input type="hidden" name="elderlyId" id="elderlyId">
                        <input type="hidden" name="elderlyIdNo" id="elderlyIdNo">
                    </div>
                    <label class="layui-form-label must">评估原因</label>
                    <div class="layui-input-inline">
                        <select name="cause" lay-verify="required" id="cause">
                            <option value=""></option>
                            <option value="1">接收服务前初评</option>
                            <option value="2">接收服务后的常规评估</option>
                            <option value="3">状况发生变化后的即时评估</option>
                            <option value="4">因评估结果有疑问进行的复评</option>
                        </select>
                    </div>
                    <div class="layui-form-mid layui-word-aux hulve" style="margin-left: 40px;">
                        若未找到该老人档案，请先<a href="/enterElderly/add" style="color: blue;">创建老人档案</a>
                    </div>
                </div>
            </div>
        </form>
        <div class="layui-tab" lay-filter="demo">
            <ul class="layui-tab-title">
                <li class="layui-this" lay-id="one">老人基本信息</li>
                <li class="layui-nav-item" lay-id="two">疾病及近30天意外事件</li>
                <li class="layui-nav-item" lay-id="three">日常生活评估</li>
                <li class="layui-nav-item" lay-id="four">精神状态评估</li>
                <li class="layui-nav-item" lay-id="five">感知觉与沟通评估</li>
                <li class="layui-nav-item" lay-id="six">社会参与评估</li>
                <li class="layui-nav-item" lay-id="seven">评估报告</li>
            </ul>
            <div class="layui-tab-content">
                <div class="layui-tab-item layui-show">
                    <table class="layui-table">
                        <colgroup>
                            <col width="200">
                            <col>
                        </colgroup>
                        <tbody>
                        <tr>
                            <td>评估基准日期</td>
                            <td id="todayDate"></td>
                        </tr>
                        <tr>
                            <td>姓名</td>
                            <td id="ename"></td>
                        </tr>
                        <tr>
                            <td>性别</td>
                            <td id="sex"></td>
                        </tr>
                        <tr>
                            <td>出生日期</td>
                            <td id="birthday"></td>
                        </tr>
                        <tr>
                            <td>身份证号</td>
                            <td id="IdNo"></td>
                        </tr>
                        <tr>
                            <td>社保卡号</td>
                            <td id="ybnum"></td>
                        </tr>
                        <tr>
                            <td>民族</td>
                            <td id="nation"></td>
                        </tr>
                        <tr>
                            <td>文化程度</td>
                            <td id="education"></td>
                        </tr>
                        <tr>
                            <td>宗教信仰</td>
                            <td id="faith"></td>
                        </tr>
                        <tr>
                            <td>婚姻状况</td>
                            <td id="wedding"></td>
                        </tr>
                        <tr>
                            <td>居住情况</td>
                            <td id="support"></td>
                        </tr>
                        <tr>
                            <td>医疗费用支付方式</td>
                            <td id="zfstatus"></td>
                        </tr>
                        <tr>
                            <td>经济来源</td>
                            <td id="fmoney"></td>
                        </tr>
                        </tbody>
                    </table>
                </div>

                <div class="layui-tab-item">
                    <form class="layui-form" id="jibingForm">
                        <table class="layui-table">
                            <colgroup>
                                <col width="150">
                                <col width="200">
                                <col>
                            </colgroup>
                            <tbody>
                            <tr >
                                <td  rowspan="3">疾病诊断</td>
                                <td>痴呆</td>
                                <td >
                                    <span><input type="radio"  name="stupid" value="0" title="0无" checked></span>
                                    <span><input type="radio"  name="stupid" value="1" title="1轻度"></span>
                                    <span> <input type="radio"  name="stupid" value="2" title="2中度"></span>
                                    <span><input type="radio"  name="stupid" value="3" title="3重度"></span>
                                </td>
                            </tr>
                            <tr>
                                <td>精神疾病</td>
                                <td >
                                    <span><input type="radio"  name="spirit" value="0" title="0无" checked></span>
                                    <span><input type="radio"  name="spirit" value="1" title="1精神分裂症"></span>
                                    <span><input type="radio" name="spirit" value="2" title="2双相情感障碍"></span>
                                    <span><input type="radio" name="spirit" value="3" title="3偏执性精神障碍"></span><br>
                                    <span><input type="radio" name="spirit" value="4" title="4分裂情感性障碍"></span>
                                    <span><input type="radio" name="spirit" value="5" title="5癫痫所致精神障碍"></span>
                                    <span><input type="radio" name="spirit" value="6" title="6精神发育迟滞伴发精神障碍"></span>
                                </td>
                            </tr>
                            <tr>
                                <td>慢性疾病</td>
                                <td id="impDisease"></td>
                            </tr>
                            <tr>
                                <td rowspan="4">近30天意外事件</td>
                                <td>跌倒</td>
                                <td >
                                    <span><input type="radio"  name="fall" value="0" title="无" checked></span>
                                    <span><input type="radio" name="fall" value="1" title="发生过 1 次"></span>
                                    <span><input type="radio" name="fall" value="2" title="发生过 2 次"></span>
                                    <span><input type="radio" name="fall" value="3" title="发生过 3 次及以上"></span>
                                </td>
                            </tr>
                            <tr>
                                <td>走失</td>
                                <td >
                                    <span><input type="radio"  name="lost" value="0" title="无" checked></span>
                                    <span><input type="radio" name="lost" value="1" title="发生过 1 次"></span>
                                    <span><input type="radio" name="lost" value="2" title="发生过 2 次"></span>
                                    <span><input type="radio" name="lost" value="3" title="发生过 3 次及以上"></span>
                                </td>
                            </tr>
                            <tr>
                                <td>噎食</td>
                                <td >
                                    <span><input type="radio"  name="foraging" value="0" title="无" checked></span>
                                    <span><input type="radio" name="foraging" value="1" title="发生过 1 次"></span>
                                    <span><input type="radio" name="foraging" value="2" title="发生过 2 次"></span>
                                    <span><input type="radio" name="foraging" value="3" title="发生过 3 次及以上"></span>
                                </td>
                            </tr>
                            <tr>
                                <td>自杀</td>
                                <td >
                                    <span><input type="radio"  name="suicide" value="0" title="无" checked></span>
                                    <span><input type="radio" name="suicide" value="1" title="发生过 1 次"></span>
                                    <span><input type="radio" name="suicide" value="2" title="发生过 2 次"></span>
                                    <span><input type="radio" name="suicide" value="3" title="发生过 3 次及以上"></span>
                                </td>
                            </tr>
                            <tr>
                                <td>信息提供者姓名</td>
                                <td colspan="2">
                                    <input type="text" name="tgName" required lay-verify="required" placeholder="请输入供者姓名" autocomplete="off" class="layui-input">
                                </td>
                            </tr>
                            <tr>
                                <td>与老人关系</td>
                                <td colspan="2">
                                    <input type="text" name="tgElderBind" placeholder="请输入与老人关系" autocomplete="off" class="layui-input">
                                </td>
                            </tr>
                            <tr>
                                <td>联系人电话</td>
                                <td colspan="2">
                                    <input type="text" name="tgPhone" required lay-verify="required|phone" placeholder="请输入联系人电话" autocomplete="off" class="layui-input">
                                </td>
                            </tr>
                            </tbody>
                        </table>
                        <button class="layui-btn" type="button" style="margin-left: 705px;" lay-submit id="jibingBtn">保存信息</button>
                    </form>
                </div>

                <div class="layui-tab-item">
                    <form class="layui-form" id="richangForm">
                        <div style="padding:5px 20px;">
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">进食</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="jinshi" value="10">
                                    <span style="white-space: nowrap;">【10分】</span>
                                    <span >可独立进食（在合理的时间内独立进食准备好的食物）</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="jinshi" value="5">
                                    <span style="white-space: nowrap;">【5分】</span>
                                    <span >需部分帮助（进食过程中需要一定帮助,将食物剪细剪碎或需要完全搅拌、协助扶着餐具等）</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="jinshi" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span >需极大帮助或完全依赖他人，或有留置营养管</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">洗澡</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="xizao" value="5">
                                    <span style="white-space: nowrap;">【5分】</span>
                                    <span >准备好洗澡水后，可自己独立完成洗澡过程</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="xizao" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span >在洗澡过程中需他人帮助</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">修饰</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="xiushi" value="5">
                                    <span style="white-space: nowrap;">【5分】</span>
                                    <span >可自己独立完成</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="xiushi" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span >需他人帮助</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">穿衣</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="chuanyi" value="10">
                                    <span style="white-space: nowrap;">【10分】</span>
                                    <span >可独立完成（自行从衣橱或抽屉里取出衣物穿戴整齐）</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="chuanyi" value="5">
                                    <span style="white-space: nowrap;">【5分】</span>
                                    <span >需部分帮助（需要帮助整理、系扣或鞋带、拉拉链） </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="chuanyi" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span >需极大帮助或完全依赖他人 </span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">大便控制</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="dabian" value="10">
                                    <span style="white-space: nowrap;">【10分】</span>
                                    <span >可控制大便</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="dabian" value="5">
                                    <span style="white-space: nowrap;">【5分】</span>
                                    <span>偶尔失控(每周<1次)，或需要他人提示</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="dabian" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span >完全失控</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">小便控制</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="xiaobian" value="10">
                                    <span style="white-space: nowrap;">【10分】</span>
                                    <span >可控制小便</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="xiaobian" value="5">
                                    <span style="white-space: nowrap;">【5分】</span>
                                    <span>偶尔失控（每天<1次，但每周>1次），或需要他人提示 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="xiaobian" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span >完全失控，或留置尿管 </span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">如厕</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="ruce" value="10">
                                    <span style="white-space: nowrap;">【10分】</span>
                                    <span >可独立完成 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="ruce" value="5">
                                    <span style="white-space: nowrap;">【5分】</span>
                                    <span>需部分帮助（需他人搀扶去厕所、需他人帮忙冲水或整理衣裤等）</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="ruce" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span >需极大帮助或完全依赖他人  </span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">床椅转移</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="zychuangyi" value="15">
                                    <span style="white-space: nowrap;">【15分】</span>
                                    <span >可独立完成</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="zychuangyi" value="10">
                                    <span style="white-space: nowrap;">【10分】</span>
                                    <span>需部分帮助（需他人搀扶或使用拐杖） </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="zychuangyi" value="5">
                                    <span style="white-space: nowrap;">【5分】</span>
                                    <span >需极大帮助（较大程度上依赖他人搀扶和帮助） </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="zychuangyi" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span >完全依赖他人  </span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">平地行走</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="pdfoot" value="15">
                                    <span style="white-space: nowrap;">【15分】</span>
                                    <span >可独立在平地上行走45米 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="pdfoot" value="10">
                                    <span style="white-space: nowrap;">【10分】</span>
                                    <span>需部分帮助（需他人的搀扶或使用拐杖、助行器等） </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="pdfoot" value="5">
                                    <span style="white-space: nowrap;">【5分】</span>
                                    <span >需极大帮助（较大程度上依赖他人搀扶，或坐在轮椅上自行移动）</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="pdfoot" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span >完全依赖他人   </span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">上下楼梯</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="sxfloor" value="10">
                                    <span style="white-space: nowrap;">【10分】</span>
                                    <span>可独立上下楼梯（连续上下10~15个台阶） </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="sxfloor" value="5">
                                    <span style="white-space: nowrap;">【5分】</span>
                                    <span >需部分帮助（需他人搀扶或扶着楼梯、使用拐杖等）</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="sxfloor" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span >需极大帮助或完全依赖他人  </span>
                                </p>
                            </div>
                        </div>
                        <button class="layui-btn" type="button"  style="margin-left: 705px;" lay-submit id="richangBtn">保存信息</button>
                    </form>
                </div>

                <div class="layui-tab-item">
                    <form class="layui-form" id="jingshenForm">
                        <div style="padding:5px 20px;">
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">认知功能</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="renzhi" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>画钟正确（画出一个闭锁圆，指针位置准确），且能回忆出2-3个词  </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="renzhi" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span >画钟错误（画的圆不闭锁，或指针位置不准确），或只回忆出0-1个词 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="renzhi" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >已确诊为认知障碍，如老年痴呆</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">攻击行为</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="kill" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>无身体攻击行为（如打/踢/推/咬/抓/摔东西）和语言攻击行为（如骂人、 语言威胁、尖叫） </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="kill" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span>每月有几次身体攻击行为，或每周有几次语言攻击行为</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="kill" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >每周有几次身体攻击行为，或每日有语言攻击行为 </span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">抑郁症状</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="yiyu" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>无</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="yiyu" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span >情绪低落、不爱说话、不爱梳洗、不爱活动 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="yiyu" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >有自杀念头或自杀行为 </span>
                                </p>
                            </div>
                        </div>
                        <button class="layui-btn" type="button"  style="margin-left: 705px;" lay-submit id="jingshenBtn">保存信息</button>
                    </form>

                </div>

                <div class="layui-tab-item">
                    <form class="layui-form" id="ganzhiForm">
                        <div style="padding:5px 20px;">
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">意识水平</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="yishi" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>神志清醒，对周围环境警觉 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="yishi" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span >嗜睡，表现为睡眠状态过度延长。当呼唤或推动患者的肢体时可唤醒，并能进行正确的交谈或执行指令，停止刺激后又继续入睡  </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="yishi" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >昏睡，一般的外界刺激不能使其觉醒，给予较强烈的刺激时可有短时的意识清醒，醒后可简短回答提问，当刺激减弱后又很快进入睡眠状态  </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="yishi" value="3">
                                    <span style="white-space: nowrap;">【3分】</span>
                                    <span >昏迷，处于浅昏迷时对疼痛刺激有回避和痛苦表情；处于深昏迷时对刺激无反应（若评定为昏迷，直接评定为重度失能，可不进行以下项目的评估）</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">视力</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shili" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>能看清书报上的标准字体</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shili" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span >能看清楚大字体，但看不清报上的标准字体</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shili" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >看不清报纸上的大标题，但是能辨认物体</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shili" value="3">
                                    <span style="white-space: nowrap;">【3分】</span>
                                    <span >辨认物体有困难，但眼睛能随物体移动，只能看到好、光、颜色和形状</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shili" value="4">
                                    <span style="white-space: nowrap;">【4分】</span>
                                    <span >没有视力，眼睛不能跟随物体移动</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">听力</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="tingli" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>可正常交流，能听到电视、电话、门铃的声音</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="tingli" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span >在轻声说话或说话距离超过2米时听不清 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="tingli" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >正常交流有些困难，需要在安静的环境或大声说话才能听到 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="tingli" value="3">
                                    <span style="white-space: nowrap;">【3分】</span>
                                    <span >需要讲话者大声说话或说话很慢才能部分听到</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="tingli" value="4">
                                    <span style="white-space: nowrap;">【4分】</span>
                                    <span >完全听不到</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">沟通交流</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="gotong" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>无困难，能与他人正常沟通和交流 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="gotong" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span >能够表达自己的需要及理解别人的话，但需要增加时间或给予帮助  </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="gotong" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >表达需要或理解有困难，需频繁重复或简化口头表达 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="gotong" value="3">
                                    <span style="white-space: nowrap;">【3分】</span>
                                    <span >不能表达需要或理解他人的话</span>
                                </p>
                            </div>
                        </div>
                        <button class="layui-btn" type="button" style="margin-left: 705px;" lay-submit id="ganzhiBtn">保存信息</button>
                    </form>
                </div>

                <div class="layui-tab-item">
                    <form class="layui-form" id="shehuiForm">
                        <div style="padding:5px 20px;">
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">生活能力</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shenghuo" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>除个人生活自理外（如饮食、洗漱、穿戴、二便），能料理家务（如做饭、洗衣）或当家管理事务</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shenghuo" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span >除个人生活自理外，能做家务，但欠好，家庭事务安排欠条理 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shenghuo" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >个人生活能自理；只有在他人帮助下才能做些家务，但质量不好</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shenghuo" value="3">
                                    <span style="white-space: nowrap;">【3分】</span>
                                    <span >个人基本生活事务能自理（如饮食、二便），在督促下可洗漱</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shenghuo" value="4">
                                    <span style="white-space: nowrap;">【4分】</span>
                                    <span >个人基本生活事务（如饮食、二便）需要部分帮助或完全依赖他人帮助</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">工作能力</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="job" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>原来熟练的脑力工作或体力技巧性工作可照常进行</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="job" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span >原来熟练的脑力工作或体力技巧性工作能力有所下降 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="job" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >原来熟练的脑力工作或体力技巧性工作明显不如以往，部分遗忘 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="job" value="3">
                                    <span style="white-space: nowrap;">【3分】</span>
                                    <span >对熟练工作只有一些片段保留，技能全部遗忘</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="job" value="4">
                                    <span style="white-space: nowrap;">【4分】</span>
                                    <span >对以往的知识或技能全部磨灭</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">时间/空间定向</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="skdingxiang" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>时间观念（年、月、日、时）清楚；可单独出远门，能很快掌握新环境的方位</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="skdingxiang" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span >时间观念有些下降，年、月、日清楚，但有时相差几天；单独来往于近街，知道现住地的名称和方位，但不知回家路线 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="skdingxiang" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >时间观念差，年、月、日不清楚，可知上半年或下半年；只能在家附近行动，对现住地只知名称，不知道方位 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="skdingxiang" value="3">
                                    <span style="white-space: nowrap;">【3分】</span>
                                    <span >时间观念差，年、月、日不清楚， 只能在左邻右舍间串门，对现住地不知名称和方位</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="skdingxiang" value="4">
                                    <span style="white-space: nowrap;">【4分】</span>
                                    <span >无时间观念；不能单独外出</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">人物定向</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="rendingxiang" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>知道周围人们的关系；知道祖孙、叔伯、姑姨等称谓的意义；可分辨陌生人的大致年龄和身份，可用适当称呼</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="rendingxiang" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span >只知家中亲密近亲的关系，不会分辨陌生人的大致年龄，不能称呼陌生人 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="rendingxiang" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >只能称呼家中人，或只能照样称呼，不知其关系，不辨辈分</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="rendingxiang" value="3">
                                    <span style="white-space: nowrap;">【3分】</span>
                                    <span >只认识常同住的亲人，可称呼子女或孙子女，可辨熟人和生人</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="rendingxiang" value="4">
                                    <span style="white-space: nowrap;">【4分】</span>
                                    <span >只认识保护人，不辨熟人和生人</span>
                                </p>
                            </div>
                            <div class="divlist">
                                <div style="font-size: 20px;background-color: lightgoldenrodyellow;">社会交往能力</div>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shehuinl" value="0">
                                    <span style="white-space: nowrap;">【0分】</span>
                                    <span>参与社会，在社会环境有一定的适应能力，待人接物恰当</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shehuinl" value="1">
                                    <span style="white-space: nowrap;">【1分】</span>
                                    <span >能适应单纯环境，主动接触人，初见面时难让人发现智力问题，不能理解隐喻语 </span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shehuinl" value="2">
                                    <span style="white-space: nowrap;">【2分】</span>
                                    <span >脱离社会，可被动接触，不会主动待人，谈话中很多不适词句，容易上当受骗</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shehuinl" value="3">
                                    <span style="white-space: nowrap;">【3分】</span>
                                    <span >勉强可与人交往，谈吐内容不清楚，表情不恰当</span>
                                </p>
                                <p  class="p-item">
                                    <input type="radio" class="radio" name="shehuinl" value="4">
                                    <span style="white-space: nowrap;">【4分】</span>
                                    <span >难以与人接触</span>
                                </p>
                            </div>
                        </div>
                        <button class="layui-btn" type="button" style="margin-left: 705px;" lay-submit id="shehuiBtn">保存信息</button>
                    </form>
                </div>

                <div class="layui-tab-item">
                    <table class="layui-table" lay-size="lg"  id="pgbg" hidden>
                        <colgroup>
                            <col >
                            <col width="200">
                            <col width="160">
                            <col width="200">
                            <col width="160">
                        </colgroup>
                        <tbody>
                        <tr>
                            <td rowspan="2">一级指标分级</td>
                            <td>日常生活活动：</td>
                            <td id="richnagpg">未评估</td>
                            <td>精神状态：</td>
                            <td id="jingshenpg">未评估</td>
                        </tr>
                        <tr>
                            <td>感知觉与沟通：</td>
                            <td id="ganzhipg">未评估</td>
                            <td >社会参与：</td>
                            <td id="shehuipg">未评估</td>
                        </tr>
                        <tr>
                            <td>老年人初步能力等级：</td>
                            <td colspan="4" id="chubupg"></td>
                        </tr>
                        <tr>
                            <td>等级变更条款：</td>
                            <td colspan="4" id="biangeng"></td>
                        </tr>
                        <tr>
                            <td>老年人最终能力等级：</td>
                            <td colspan="4" id="zuizhongpg"></td>
                        </tr>
                        <tr>
                            <td colspan="5">
                                <div><span>评估员签名：</span><span class="leftone">日期</span><span class="two">年</span><span class="one">月</span><span class="one">日</span></div><br>
                                <div><span>提供信息者签名：</span><span class="lefttwo">日期</span><span class="two">年</span><span class="one">月</span><span class="one">日</span></div>
                            </td>
                        </tr>
                        <tr>
                            <td colspan="5">
                                <div class="one">
                                    <span class="weight">注：</span>
                                    <span>老年人能力初步等级划分标准</span>
                                </div><br>
                                <div>
                                    <div class="weight">0 能力完好：</div><br>
                                    <div class="one">日常生活活动、精神状态、感知觉与沟通分级均为 0，社会参与分级为 0 或 1</div><br>
                                </div>
                                <div>
                                    <div class="weight">1 轻度失能：</div><br>
                                    <div class="one">日常生活活动分级为 0，但精神状态、感知觉与沟通中至少一项分级为 1 及以上，或社会参与的分级为 2；</div><br>
                                    <div class="one">或日常生活活动分级为 1，精神状态、感知觉与沟通、社会参与中至少有一项的分级为 0 或 1</div></div><br>
                                <div>
                                    <div class="weight">2 中度失能：</div><br>
                                    <div class="one">日常生活活动分级为 1，但精神状态、感知觉与沟通、社会参与均为 2，或有一项为 3；</div><br>
                                    <div class="one">或日常生活活动分级为 2，且精神状态、感知觉与沟通、社会参与中有 1-2 项的分级为 1 或 2</div><br>
                                </div>
                                <div>
                                    <div class="weight">3 重度失能：</div><br>
                                    <div class="one">日常生活活动的分级为 3；</div><br>
                                    <div class="one">或日常生活活动、精神状态、感知觉与沟通、社会参与分级均为 2；</div><br>
                                    <div class="one">或日常生活活动分级为 2，且精神状态、感知觉与沟通、社会参与中至少有一项分级为 3</div>
                                </div>
                            </td>
                        </tr>
                        </tbody>
                    </table>
                    <div class="layui-form-item hulve">
                        <div class="layui-input-block">
                            <a  href="javascript:void(0)"  class="layui-btn layui-btn-normal" id="dy">打印评估表</a>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
</html>

<div class="xuanfu" id="xuanfu2" hidden>
    <div class="one" style="margin-top: 20px;"><span>沟通交流 :</span><span class="one" id="score2">0</span></div><br>
    <div class="one"><span>感知觉与沟通分级:</span><span class="one" id="pjresult2">能力完好</span></div><br>
    <div class="one"> <div>评估标准：</div>
        <div>0 能力完好：</div><div class="one">意识清醒，且视力和听力评为 0 或 1，沟通评为 0</div>
        <div>1 轻度受损：</div><div class="one">意识清醒，但视力或听力中至少一项评为 2，或沟通评为 1</div>
        <div>2 中度受损：</div><div class="one">意识清醒，但视力或听力中至少一项评为 3，或沟通评为 2；或嗜睡，视力或听力评定为 3 及以下，沟通评定为 2 及以下</div>
        <div>3 重度受损：</div><div class="one">意识清醒或嗜睡，但视力或听力中至少一项评为 4，或沟通评为 3；或昏睡/昏迷</div>
    </div>
</div>
<div class="xuanfu" id="xuanfu" hidden>
    <div class="one" style="margin-top: 20px;"><span id="xiangmu">日常生活活动总分 :</span><span class="one" id="score">0</span></div><br>
    <div class="one"><span id="xiangmufj">日常生活活动分级:</span><span class="one" id="pjresult">能力完好</span></div><br>
    <div class="one"> <div>评估标准：</div>
        <span>0 能力完好：</span><span class="one" id="xfone">总分 100 分</span><br>
        <span>1 轻度受损：</span><span class="one" id="xftwo">总分 65-95 分</span><br>
        <span>2 中度受损：</span><span class="one" id="xfthree">总分 45-60 分</span><br>
        <span>3 重度受损：</span><span class="one" id="xffour">总分≤40 分</span>
    </div>
</div>
<div class="xuanfu" id="xuanfu1" hidden>
    <div class="one" style="margin-top: 20px;"><span>等级变更条件 :</span><span class="one" id="score1">无</span></div><br>
    <div class="one"> <div>评估标准：</div>
        <span class="one">1、有认知障碍/痴呆、精神疾病者，在原有能力级别上提高一个等级；</span><br>
        <span class="one">2、近 30 天内发生过 2 次及以上跌倒、噎食、自杀、走失者，在原有能力级别上提高一个等级；</span><br>
        <span class="one">3、处于昏迷状态者，直接评定为重度失能；</span><br>
        <span class="one">4、若初步等级确定为“3 重度失能”，则不考虑上述 1-3 中各情况对最终等级的影响，等级不再提高 </span>
    </div>
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